Chiang Dao Hospital

On Monday we started off the day with a two hour drive to get to Chiangdao Hospital in Chang Dao, Thailand. In this northern part of Thailand the people speak a different dialect, mainly live in tribes and this area has a lot of poverty. When we arrived at the hospital we listened to a lecture presented by Dr. Kudchaporn Intravong about Chiangdao Hospital and the care they offer to their patients with HIV/AIDs and/or tuberculosis. We learned that this hospital has 60 beds and most of the patients are from ethnic minorities. Along with medical care, psychological care, socioeconomic care and home health care, the hospital sets up PHA (people who’re living with HIV and AIDs) so they have a support network. Similarly to America, this hospital has a multidisciplinary approach for patients who have HIV/AIDs and the team consists of PHA, doctors, nurses, pharmacists, volunteers and health officers. Next we listened to a lecture presented by a pharmacist who works at pharmacy located in the part of the hospital that has all of the specialized clinics. After our lectures, we were taken on a tour to explore the hospital. Like many other hospitals in Thailand, this hospital was partially inside and partially outside and there was very limited air conditioning. I saw several stray dogs and cats roaming around the hospital. In the first part of the tour we were brought to the different clinics including HIV, TB, HTN, CKD, DM, methadone and NCD. There are usually around 40 patients per day in each clinic. Usually when patients come to the clinics, they will first see the nurses, then the doctors and finally the pharmacists. From here we were brought to the Medical Laboratory where we saw how the staff look under microscopes to examine TB and have an ELISA machine to determine the patients’ viral load of HIV. The next location we got to see was the emergency room. In the emergency room, the nurse said most of the patients present with trauma from motor vehicle accidents, more specifically motorbikes without helmets. The nurse explained that every month there are about 300 cases of Dengue Fever and about half of the cases are hemorrhagic Dengue Fever. Fortunately, less than 5% of these cases turn into Dengue Shock. After this we went to see the Delivery Room. In this hospital they deliver babies that have HIV + or HIV – mothers, therefore the pharmacist showed us the medication they give the HIV + mothers before the babies are born. There were two women in labor here with large straps around their bellies. Instead of getting epidurals, like we do in the United States, the treatment of choice for women in labor is massaging the abdomen. Where the two women were located was a small room with maybe 5 or 6 beds in it (very little privacy) and no air conditioning so it was very hot! I was surprised to learn that no family members were allowed to be in this room with the mother as she prepared to give birth. When it is time to actually deliver the baby, the mom gets moved to another more private room. After the tour we walked back to the air conditioned conference room to cool down and eat lunch. It was a busy hospital and we are thankful all of the staff took so much time out of their days to teach us.